1. Field of the Invention
The present invention generally relates to health care claim reimbursement systems and methods.
2. Description of the Related Art
The approaches described in this section could be pursued, but are not necessarily approaches that have been previously conceived or pursued. Therefore, unless otherwise indicated herein, the approaches described in this section are not teachings or suggestions of the prior art to the claims in this application and are not admitted to be prior art by inclusion in this section.
There was a time when people needed medical attention they paid the doctor directly for his or her professional services. Times have changed. Modern medicine can work miracles our grandparents never dreamed of, but sometimes at a staggering price. The provision of critical healthcare treatment is often regarded as a basic human right, regardless of whether the individual has the means to pay—at the same moment some forms of healthcare treatment cost more than a typical family's life savings. These days most Americans rely on a third party—either a private insurer, or a public governmental entity—to help them finance the cost of their medical needs.
Today, the healthcare industry is a huge business, with many large managed care companies traded on the stock exchange. The healthcare industry accounts for approximately $1.5 trillion in market revenue. The added complexities of the current health care system and the sheer volume of medicines being manufactured and administered has resulted in a long payment cycle. Today's health care organizations and individual providers face challenges processing and getting reimbursed for medical insurance claims, as well as determining fair reimbursement amounts.